Prevalence, consequences and factors associated with drug use among individuals over 50 years of age in the family perspective.

OBJECTIVES: The aim of this study was to investigate the prevalence, consequences and factors associated with drug use among individuals over 50 years of age, from the perspective of their families, with particularly reference to cocaine use. METHODS: Cross-sectional study based on secondary data with 624 family members of substance users who sought family support in 14 units of the Recomeço Família Program in São Paulo, Brazil. RESULTS: The participants were predominately men, aged 50 to 59 years (68%); cocaine users (inhaled and/ or smoked); living alone; with a low level of education and were unemployed. They were likely to use family money to pay for their substance use, with a history of theft and aggression against strangers, and were not in treatment. Unlike other participants [≥ 60 years (31.1%)]; who were better educated and retired. In this latter group, 32.8% are alcohol users, 14.8% cocaine users (inhaled and smoked), 32.6% has physically assaulted their family, 39.7% had assaulted someone else and 18.3% had stolen objects or money from home. CONCLUSIONS: The population has peculiar characteristics of vulnerability (cocaine use and violence) that remain under investigated; not only do routes into treatment for older adults (≥ 60) but appropriate treatment packages need to be developed too.

The experience of the partners of women with breast cancer.

OBJECTIVE: To understand the experience of partners of women with breast cancer. METHOD: This was a qualitative study, based on the theoretical-methodological framework of existential and phenomenological psychology, and carried out with the partners of women with breast cancer who attended a center for rehabilitation after mastectomy. The data were collected in interviews between June and November 2014, based on a guiding question. RESULTS: Ten partners participated in the study. On discovering the disease, the partners experienced emotional distress caused by the fear of losing their partners. Before this suffering, they demonstrated the ability to react: willingness to provide care, to comfort and to support the women in search of treatment, and together, seek to reverse adverse situations. They also showed sensitivity and recognized the intense emotional suffering of the women caused by the challenges faced throughout the course of treatment. CONCLUSION: The present study showed the intense suffering of the partners of women with breast cancer and their difficulty to ask for help. Thus, health professionals must be alert, addressing their needs throughout the treatment process to mitigate suffering.

Attitudes of nursing students towards substance users and perceptions about religious/spiritual care.

OBJECTIVE: To evaluate the impact of an educational intervention on the attitudes of Nursing students towards users of psychoactive substances (excluding alcohol and tobacco) and their perceptions about the religious and spiritual care offered within the health services. METHOD: Quasi-experimental study. We applied a questionnaire before and one month after an intervention about the comprehensive care of substance users, containing: sociodemographic information, knowledge, the Treatment Spirituality/Religiosity Scale, and the Drug and Drug Problems Perceptions Questionnaire. For the analyses, we employed the paired Student's t-test and Pearson's Coefficient. RESULTS: 62 students participated in this study. After the intervention, there was improvement in the students' attitudes towards the substance users, but not regarding the perception they already had about the importance of offering religious and spiritual care within the services. CONCLUSION: We verified the effectiveness of the educational intervention on the improvement of attitudes concerning the care of substance users, yet we point out that the students did not show changes in their perception about the inclusion of the religious and spiritual aspects in the care dedicated to this population.

Alcohol use and health behavior among nursing professionals. / Uso de álcool e comportamento de saúde entre profissionais da enfermagem.

OBJECTIVE: To evaluate the problematic use of alcohol and health behavior among the nursing staff of a general hospital. METHOD: Cross-sectional study conducted at a general hospital. A questionnaire with socio-demographic information, the alcohol and substance use screening test, and a questionnaire on health behavior were applied. RESULTS: A total of 416 professionals participated in the study. In the final model of logistical regression, male professionals (OR 4.3), singles (OR 3.7), those that professed to having other religions (OR 3.8), worked as nursing technician (OR 2.3), did not consume low doses of alcoholic beverages per day (OR 2.0), used tobacco (OR 8.9), avoided consuming beverages with caffeine (OR 1.9) and avoided noisy environments (OR 2.0) showed higher chances of consuming alcohol at a problematic level. CONCLUSION: Among nursing professionals, the use of alcohol and not engaging in health behavior are strongly associated. These findings have implications for the implementation of strategies for the promotion of health and the prevention of alcohol use in work relationships.

[Adherence to nutritional recommendations and sociodemographic variables in patients with diabetes mellitus]. / Adesão às recomendações nutricionais e variáveissociodemográficas em pacientes com diabetes mellitus.

OBJECTIVE: To determine if there is a relationship between adherence to nutritional recommendations and sociodemographic variables in Brazilian patients with type 2 diabetes mellitus. METHODS: Cross-sectional observational study using a stratified random sample of 423 individuals. The Food Frequency Questionnaire (FFQ) was used, and the Fisher's exact test was applied with 95% confidence interval (p<0.05). RESULTS: Of the 423 subjects, 66.7% were women, mean age of 62.4 years (SD = 11.8), 4.3 years of schooling on average (SD = 3.6) and family income of less than two minimum wages. There was association between the female gender and adherence to diet with adequate cholesterol content (OR: 2.03; CI: 1.23; 3.34), between four and more years of education and adherence to fractionation of meals (OR: 1 92 CI: 1.19; 3.10), and income of less than two minimum wages and adherence to diet with adequate cholesterol content (OR: 1.74; CI: 1.03, 2.95). CONCLUSION: Adherence to nutritional recommendations was associated with the female gender, more than four years of education and family income of less than two minimum wages.

[Use of alcohol in the elderly: transcultural validation of the Michigan Alcoholism Screening Test - Geriatric Version (MAST-G)]. / Uso do álcool em idosos: validação transcultural do Michigan Alcoholism Screening Test - Geritatric Version (MAST-G).

OBJECTIVE: To evaluate the internal consistency of the version of the Michigan Alcoholism Screening Test - Geriatric Version (MAST-G) instrument, translated and adapted for Brazil. METHOD: This was a descriptive, cross-sectional study. Data were collected through a demographic questionnaire, the ICD-10 and the MAST-G, following the steps of translation and cultural adaptation. One hundred eleven elderly in the city of São Carlos, SP, Brazil were interviewed. RESULTS: The mean age of those interviewed was 70 years, with 45% men and 55% women, with the mean education of three years; 92% resided with family; 48% of the subjects consumed alcoholic beverages. The MAST-G presented a good level of reliability, with Cronbach's α = 0.7873, and good levels of sensitivity and specificity with a cutoff score of five positive responses. CONCLUSION: The Brazilian version of the MAST-G presented internal consistency values similar to the original English version,showing it to be adequate for use in the national context.

[Adherence to diabetes mellitus treatments in family health strategy units]. / Adesão ao tratamento em diabetes mellitus em unidades da Estratégia Saúde da Família.

This cross-sectional study aimed to analyze the adherence to drug and non-drug treatments in 17 Family Health Strategy units. A total of 423 patients with type 2 diabetes mellitus were selected through stratified random sampling in Family Health Strategy units of a city in the state of Minas Gerais, Brazil, in 2010. The results showed that the prevalence rate of adherence to drug therapy was higher than 60% in the 17 units investigated; in relation to physical activity, adherence was higher than 60% in 58.8% units; and for the diet plan, there was no adherence in 52.9% units. Therefore, we concluded that adherence to drug therapy in most units was high and the practice of physical activity was heterogeneous, and in relation to diet adherence, it was low in all units. We recommend strengthening of institutional guidelines and educational strategies, in line with SUS guidelines, so that, professionals may face the challenges imposed by the lack of adherence.

Lesbian and bisexual couples experiencing dual motherhood: (dis)encounters in the provision of healthcare. / Casais de mulheres lésbicas e bissexuais que vivenciam a dupla maternidade: (des)encontros na produção do cuidado em saúde.

The bond with healthcare services is a crucial dimension in facilitating the maternal journey of lesbian and bisexual women couples. This study aimed to analyze the culturally constructed meanings regarding the bond with healthcare services and professionals by lesbian and bisexual women who experienced dual motherhood. It is a qualitative investigation grounded in interpretative anthropology. The research corpus was built based on in-depth interviews with 10 lesbian and bisexual women, aged 30 to 39 years. The results indicate that access to parenthood, until its realization, involved a journey permeated by satisfactions and sufferings triggered by failed attempts and gestational losses. Challenges experienced in healthcare provision were also reported due to prejudices, lack of empathy, and unpreparedness of professionals in dealing with prenatal care for lesbian and bisexual women couples. Manifestations of discrimination were more pronounced concerning non-gestational mothers. The findings offer insights into implementing policies that prioritize humanization and planning programs and healthcare services based on culturally sensitive care for lesbian and bisexual women couples as they transition into dual motherhood.

O vínculo com os serviços de saúde é uma dimensão crucial para viabilizar o projeto materno de casais de mulheres lésbicas e bissexuais. Este estudo teve como objetivo analisar os significados culturalmente construídos sobre o vínculo com os serviços e profissionais de saúde por mulheres lésbicas e bissexuais que vivenciaram a dupla maternidade. Investigação qualitativa fundamentada na antropologia interpretativa. O corpus de pesquisa foi construído com base em entrevista em profundidade com 10 mulheres de 30 a 39 anos. Os resultados mostram que o acesso à parentalidade implicou um itinerário permeado por satisfações e sofrimentos devido a tentativas frustradas e perdas gestacionais. Também foram relatados percalços vivenciados na produção do cuidado em saúde devido a preconceitos, falta de empatia e despreparo de profissionais para lidarem com acompanhamento de pré-natal aos casais de mulheres lésbicas/bissexuais. As manifestações de discriminação foram mais contundentes em relação às mães não gestantes. Os resultados oferecem subsídios para implementação de políticas de humanização e planejamento de programas e serviços de saúde baseados em cuidados culturalmente sensíveis à diversidade para casais de mulheres lésbicas/bissexuais que vivenciam a transição para a maternidade.

[Quality of life in patients with diabetes mellitus before and after their participation in an educational program]. / Qualidade de vida de pacientes com diabetes mellitus antes e após participação em programa educativo.

This quasi-experimental study aimed to evaluate the health-related quality of life in individuals with diabetes mellitus before and after their participation in a five-month educational program in a primary care service in Brazil in 2008. The sample consisted of 51 individuals, 56.9% female and 43.1% male, who had a mean age of 57.65 ± 11.44 years. Data were collected using the Portuguese version of the SF-36 questionnaire. The instrument had adequate reliability estimates for the study sample. Cronbach's alpha for the two components of the instrument, physical and mental, were 0.83 and 0.89, respectively. The findings suggested improvements in all the domain components; however, only the general health domain, before (63.96 ± 19.03) and after (70.59 ± 17.82) the educational program, presented statistically significant mean differences, t(50) = 2.16, p<0.05. Participation in the educational program also contributed to improvements in the perceptions of the individuals regarding their general health status.

Bittersweet transformative experiences in professionals working with suicidal patients: a meta-synthesis.

OBJECTIVES: To synthesize and reinterpret findings from primary qualitative studies on the emotional experience of health care professionals working with mental health and mental health professionals providing care for people with suicidal behavior. METHODS: We conducted a systematic review of the literature with the SPIDER structured search strategy in six databases (PubMed, Web of Science, Scopus, PsycINFO, CINAHL, and LILACS). A meta-synthesis was performed with data from qualitative studies published between 2005 and 2021. Two independent reviewers screened and assessed the articles. They evaluated methodological quality of included articles, extracted data, and performed the thematic synthesis. RESULTS: Of 852 articles, 21 met the inclusion/exclusion criteria and were synthesized. The meta-synthesis revealed three descriptive themes: coping with adverse experiences; coming across fortunate experiences; professional-personal implications. Based on these descriptive themes, we elaborated the analytical theme: bittersweet experiences of personal and professional transformation. CONCLUSIONS: Mental health professionals working with people manifesting suicidal behaviors must cope with complex emotional experiences that involve controversial and ambivalent feelings. Such feelings have repercussions that may transform personal and professional life. The present results are useful for the development and implementation of interventions that promote better overall mental health outcomes for healthcare providers.

Perceptions of health professionals in providing care for people with anorexia nervosa and bulimia nervosa: a systematic review and meta-synthesis of qualitative studies.

This study sought to synthesize and reinterpret findings from primary qualitative studies on the experience of health professionals in caring for people with anorexia nervosa and bulimia nervosa. We conducted a systematic review of the literature with the SPIDER search strategy assessing six databases. A meta-synthesis was performed with data from qualitative studies. Two independent reviewers screened and assessed the articles, extracted data from the articles and elaborated thematic synthesis. Nineteen articles met the inclusion/exclusion criteria. The meta-synthesis revealed three descriptive themes: Going outside the comfort zone: hard relational experiences of health professionals in providing care for people with anorexia nervosa and bulimia nervosa; Reflecting on treatment: relevance of discussion, communication, and flexibility in health professionals' work with anorexia nervosa and bulimia nervosa; and Dealing with ambivalences: experiences of health professionals with family members of people with anorexia nervosa and bulimia nervosa. We elaborated two analytical themes: Making work with eating disorders palatable: malleability necessary for health professionals in bonding with people with anorexia and bulimia nervosa and their families; and Leaving the professional comfort zone: transition from multi to interdisciplinary. Thus, mental health professionals who work with people diagnosed with anorexia and bulimia nervosa cope with hard emotional experiences that makes them feel out of their comfort zone, requiring flexibility to benefit a good therapeutic alliance, but there are still difficulties in promoting interdisciplinarity.

Changing face-to-face psychological care to remote mode: facilitators and obstacles in the COVID-19 pandemic. / Cambio de la atención psicológica presencial a modalidad remota: facilitadores y obstáculos en la pandemia de COVID-19.

OBJECTIVE: to verify associations between sociodemographic variables and factors that facilitate and hinder the transition from face-to-face psychological care to remote mode in the first year of the COVID-19 pandemic. METHOD: this is an analytical, quantitative, cross-sectional study. After approval by the Research Ethics Committee, data collection was performed by applying an online form consisting of 55 questions. Data were analyzed using descriptive and inferential statistics techniques. RESULTS: the intentional sampling consisted of a total of 385 Brazilian psychologists, mostly women (67.01%), young professionals with up to five years of graduation (44.16%) most of activities in the private clinic. It was found that training time between five and 10 years was associated with a greater perception of difficulties and that previous experience with remote care facilitated adaptation in the transition from one modality to another. CONCLUSION: considering that call center can be a powerful tool in the health scenario, it is suggested the inclusion of remote care issues in the research agenda and syllabus in the curricula of health training courses.

Family grief during the COVID-19 pandemic: a meta-synthesis of qualitative studies.

The COVID-19 pandemic has led to a public health crisis, with increases in the number of deaths. As a result, the number of bereaved people has increased significantly. In addition, the measures adopted to control the spread of virus have triggered changes in the subjective and collective bereavement experiences. This systematic literature review aims to summarize and reinterpret the results of qualitative studies on the experience of losing family members during the pandemic by a thematic synthesis. The searches were performed in the Web of Science, Scopus, PubMed/MEDLINE, CINAHL, PsycINFO, and LILACS databases. Among 602 articles identified, 14 were included. Evidence was assessed using the Critical Appraisal Skills Programme tool. Two descriptive themes related to the objective were elaborated in addition to one analytical theme, namely: "Pandemic grief: lonely and unresolved". These themes proved to be interrelated and indicate that experiences of loss in this context were negatively impacted by the imperatives of physical distance, restriction of hospital visits, technology-mediated communication, and prohibition or restriction of funerals. These changes resulted in experiences marked by feelings of loneliness and helplessness, which should be considered when planning intervention strategies that favor communication between family members with the afflicted loved one and with the health care team, enabling welcoming and creating alternatives for farewell rituals. The findings may support further research to test intervention protocols, especially to guide public policies and promote psychological support to bereaved family members after their loss.

Is social isolation during the COVID-19 pandemic a risk factor for depression?

OBJECTIVE: To assess factors associated with depression among higher education students and professionals during the peak of the COVID-19 pandemic. METHOD: quantitative study with a cross-sectional design. 550 students and professionals participated. The data were collected by means of a digital questionnaire that included Patient Health Questionnaire-9 to assess depressive symptoms. RESULTS: The factors related to depression and social isolation outcomes were significantly associated with the female gender (n= 149; 37,8%; Odds Ratio OR=2,0), white (n=127; 37,2%; OR=1,60), young people (n=130; 39,4%; OR=2,0), without religion (n=70; 40,2%; OR=1,64), with financial problems (n=80; 53,0%; OR=2,40) and family problems (n=98; 47,3%; OR=1,77); who suffered violence during the quarantine (n=28; 58,3%; OR=2,33), increased the use of illicit drugs (n=16; 59,3%; OR=2,69), used sedatives without a medical prescription (n=75; 54,0%; OR=2,94), lived in conflicting relationships (n=33; 54,1%;OR=2,14), lost their job during the pandemic (n=32; 59,3%; OR=1,99) and presented symptoms of anxiety related to COVID-19 (n=155; 45,2%; OR=3,91). CONCLUSION: there is a meaningful relationship between vulnerability and adopting risk behaviors during the pandemic-imposed social isolation with depressive symptoms. We suggest that health professionals be attentive to the need to adjust their psychosocial interventions when promoting strategies when promoting strategies to mitigate the effects and risks to mental health.

[Social representations of people with diabetes regarding their perception of family support for the treatment]. / Representações sociais de pessoas com diabetes acerca do apoio familiar percebido em relação ao tratamento.

The objective of this qualitative study was to identify the social representations that people with diabetes have on their perception of family support for the treatment. The Theory of Social Representations was used as the theoretical and methodological framework. Participants were 41 people with diabetes assisted at a university in the state of São Paulo in 2007. The focal group strategy was used for data collection, and thematic content analysis was performed. Results revealed three categories: family support is present in the everyday life of people with diabetes; the family does not always support the person with diabetes in his or her needs; the person with diabetes assumes the responsibility to trigger family support. Participants see family support as a relevant factor for the treatment, but they also point out that excessive control from relatives limits their autonomy and originates ambiguous feelings. The multiprofessional team must take into consideration that knowing social representations helps improve the health care delivered to people with diabetes.

Nursing as a mediator between nomophobia and social isolation in response to COVID-19.

OBJECTIVE: To reflect on the relationship between the nomophobia and the pandemic of COVID-19 and the nursing contributions to deal with this issue and its consequences. METHOD: This reflective and theoretical study was based on the dialogue between the scientific literature on the subject and in dialogue and conceptual perspective of comprehensive care. RESULTS: Nursing strives to harmonize observed problems and can support individuals to reflect and discover a potential harmful habit regarding the use of cell phones, especially when undergoing treatments for other diagnoses. FINAL CONSIDERATIONS: Nursing, when accessing the emotional and subjective aspects of those under their care, helps to alleviate the symptoms of nomophobia and, in tune with the patient, promotes harmony in the face of the COVID-19 pandemic.

Hermeneutic comprehensions on female vulnerabilities belonging to the collective of lesbians, bisexuals, and transexuals.

OBJECTIVE: To reveal the comprehension of women and health professionals about the feminine vulnerability belonging to the collective of lesbians, bisexuals, and transsexuals' women. METHOD: Qualitative research, carried out from October 2018 to March 2019, in a Basic Health Unit located in Marabá - Pará, Brazil, using the hermeneutic-dialectic circle and inductive hermeneutic analysis. Five lesbians, bisexuals, and transsexuals' women and five health professionals participated, through interviews. RESULTS: Health care for women, as described by the participants, promoted social and programmatic vulnerabilities structured by taboos and preconception, which endorsed exclusive professional behaviors in the provision of specific care, which consequently amplified risks and threatened the quality of life of this population. CONCLUSION: The dissemination of this evidence is configured as an indicator to support future decisions regarding priorities, application of resources and professional training in the care of lesbians, bisexuals and transsexuals' women.

Explanatory models of families of children with type 1 diabetes mellitus.

OBJECTIVES: to analyze how children with type 1 diabetes mellitus and their families explain the pathology, based on their understanding of the factors related to the discovery of diabetes, the etiology, treatment, and prognosis of the disease. METHODS: qualitative methodological approach, based on medical anthropology and the narrative method. In-depth interviews were conducted with 12 families of children with type 1 diabetes mellitus attending follow-up consultations at a specialized center. The statements were subjected to inductive thematic analysis. RESULTS: the explanatory models identified describe the families search for the clarification of the signs and symptoms that the child had. Faced with the disease, families reorganized themselves to meet new health care needs of children, such as adequate nutrition, physical exercise, and blood glucose monitoring. Final Considerations: knowing the explanatory models allows the understanding of how families give meaning to the child's illness, favoring daily nursing care and an effective control of the disease.

Freedom-deprived women: social representations of prison, violence, and their consequences.

OBJECTIVE: To understand the social representations that women deprived of their freedom have of imprisonment, violence, and their consequences. METHOD: An exploratory-descriptive qualitative study with 15 women from a female penitentiary in the State of São Paulo, Brazil. Semistructured interview was used. Data submitted to thematic content analysis and interpreted under Social Representations. RESULTS: Categories identified: "Enclosed and abandoned in the prison environment": loss of contact with relatives, difficulties living in prison, and right to be reinserted into society. "Imprisoned in a cycle of social inequality": lack of support, access to education and employment opportunities, leading them to engage in new illicit activities and consequent imprisonment. FINAL CONSIDERATIONS: The social representations of prisoners suggest that they perceive themselves to be doubly "imprisoned", either from the objective point of view, as an individual deprived of freedom; or subjective, as citizens who have their rights disrespected and their possibilities of rehabilitation limited by the prison system.

Nursing students: medication use, psychoactive substances and health conditions.

OBJECTIVE: to assess the use of nonprescription psychoactive medications and their associations with psychoactive substance use and health aspects among nursing students. METHOD: a cross-sectional study conducted with 182 students at a nursing school in the city of Vale do Ribeira, Brazil. Sociodemographic information, screening for alcohol, tobacco and other drug use, information on physical and mental health and physical activity practices were assessed. RESULTS: more than half of the students (79.2%) used psychoactive drugs without prescription, with a predominance of monthly consumption. Consumption of these drugs was found to be associated with alcohol use, binge drinking, smoking and illicit drug use. CONCLUSION: the findings have implications for the implementation of health promotion strategies among nursing students, in view of lifestyle changes.